Combined cutaneous tumors with a melanoma component: A clinical, histologic, and molecular study

J Am Acad Dermatol. 2015 Sep;73(3):451-60. doi: 10.1016/j.jaad.2015.06.005. Epub 2015 Jul 21.

Abstract

Background: The histogenesis and clinical behavior of combined cutaneous tumors (CCTs) in which the mesenchymal component consists of melanoma remain unclear.

Objective: We sought to characterize the clinical, histologic, and molecular findings in CCTs with an epithelial and a melanoma component.

Methods: We retrospectively reviewed the records from 2 institutions for CCTs. Fluorescence in situ hybridization was performed to assess chromosomal copy number alterations in both components.

Results: Sixteen CCTs were included. The most common subtype was the squamomelanocytic tumor (11), followed by the basomelanocytic tumor (3) and the trichoblastomelanoma (2). CCTs were more common in men (87%), on the head and neck (57%), and had extensive solar elastosis (81%). The median follow-up was 25 months (range, 8-167 months). One case had an adverse outcome. Fluorescence in situ hybridization revealed chromosomal alterations in approximately 55% of the cases. Five cases showed chromosomal gains only in the melanocytic component. One case showed 11q13 gains in both the epithelial and melanocytic components.

Limitations: Our study is retrospective and the sample is small.

Conclusions: The low incidence of adverse outcomes suggests that CCT may be more indolent than noncombined tumors. 11q13 amplification in both components supports the theory of dual differentiation from a common progenitor cell.

Keywords: basomelanocytic tumor; biphenotypia; combined tumor; fluorescence in situ hybridization; melanoma; squamomelanocytic tumor; trichoblastomelanoma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biopsy, Needle
  • Carcinoma, Basal Cell / pathology*
  • Carcinoma, Squamous Cell / pathology*
  • Cohort Studies
  • Female
  • Humans
  • Immunohistochemistry
  • In Situ Hybridization, Fluorescence
  • Male
  • Melanoma / pathology*
  • Middle Aged
  • Molecular Biology
  • Neoplasms, Complex and Mixed / pathology*
  • Neoplasms, Multiple Primary / pathology*
  • Nevus, Spindle Cell / pathology*
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / pathology*